When I saw the mom in person (yes, I'm hospital-based), I wasn't as
convinced of thrush as I was from the phone conversation.  (Proof
that phone "diagnosis" really isn't reliable.)  Nipples weren't as
shiny as I had gathered from the phone.  Discomfort was primarily on
latch and some "shooting" pain afterwards, so I did suggest Ca/Mg
for possible ductal spasms.  Nipples were "new tube of lipstick"
shape after feeding, so worked on refining the latch.  Mom reporeted
this helped, although not completely.  Some may be residual
discomfort as the injury already there takes a little time to heal
completely.
However, there was that small amount of white on the tongue before
nursing (which, in my opinion, negates the idea it's milk on the
tongue which simply needs to be wiped off!) as well as baby's diaper
rash and now mom's small rash under one breast that still could
signal thrush.  I recommended that the mom keep an eye on the tongue
(now doesn't that give a ridiculous picture if you take it
literally) and talk to the doc again if it is increasing.
We use the TLC program and print up a report of each consult which
goes into the baby's record.  A photocopy of this report is then
sent to the baby's doc.  I have had several thank me for the report
when they see me in the hall.  When we developed our current version
of the outpatient visits, I wrote up a fictional consult report a
copy of which was given out at a Peds meeting and was in the minutes
for those not in atendance.  At that time, several commented on how
helpful they felt the reports would be.  Of course, if I have an
urgent concern about baby's health, I also phone the doc while mom
in there.  Examples might be:
1-baby looks very jaundiced and I ask if they want a bili drawn by
lab since baby is already at the hospital to see us
2-doc has ordered supplementation but after working with latch, baby
shows great milk transfer and/or mom's supply has really kicked in
since the office visit.  I will discuss holding off on the
supplementation and checking the weight again in 24-48 hours.  Most
are very open to this.  (When the baby's condition is too fragile to
allow for this, they are usually already readmitted.)
Communication with the docs does help and I have seen some change
their positions over time, but it is frustrating that it frequently
happens too slow for the mom in immediate need.

Winnie

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